Wetz, Anna Julienne

[["dc.bibliographiccitation.artnumber","183"],["dc.bibliographiccitation.journal","CRITICAL CARE"],["dc.bibliographiccitation.volume","19"],["dc.contributor.author","Wetz, Anna J."],["dc.contributor.author","Braeuer, Anselm"],["dc.contributor.author","Quintel, Michael"],["dc.contributor.author","Heise, Daniel"],["dc.date.accessioned","2018-11-07T09:58:22Z"],["dc.date.available","2018-11-07T09:58:22Z"],["dc.date.issued","2015"],["dc.description.abstract","Introduction: Postoperative acute kidney injury (AKI) is a frequently observed phenomenon after cardiac surgery with cardio-pulmonary bypass (CPB); this severe complication is associated with adverse patient outcomes. There are multiple mechanisms involved in AKI during cardiac surgery, including CPB-dependent hemolysis. An IV infusion of sodium bicarbonate, which leads to urine alkalization, may play a role in preventing AKI. Recently, several trials have investigated the effect of sodium bicarbonate and reported controversial results. The purpose of this investigation was to investigate the following question. Under what circumstances can sodium bicarbonate prevent postoperative AKI? Methods: We analyzed data from 342 patients undergoing CPB surgery at the University Hospital Goettingen, Germany. A total of 174 patients received a preemptive dose of sodium bicarbonate. Directly after the induction of anesthesia, the continuous infusion of 0.15 mmol/kg body weight/h was started and continued until 2 pm on the first postoperative day. Patients who were not treated with sodium bicarbonate formed the control group (n = 168). To verify the AKI risk configuration of each group, we surveyed risk factors and determined the commonly used clinical predictive score according to Thakar and colleagues. We recorded the concentration of free hemoglobin (fhb) to estimate the amount of CPB-dependent hemolysis. The definition of AKI was acquired by applying the AKI-network (AKIN) classification over the course of five postoperative days. Results: Patients who received the sodium bicarbonate infusion showed a significantly lower incidence (35.6 vs. 50%) of AKI than that of patients who did not receive the infusion (p = 0.01). AKIN levels 2 and 3 were also more frequent when sodium bicarbonate was not administered. Particularly, in the low-risk cohort (<3 Thakar points), the incidence of AKI was significantly reduced (26 vs. 46%) when patients received sodium bicarbonate (p = 0.01), whereas in the high-risk patients, no significant reduction was observed. Conclusion: In this study, we observed that low-risk patients particularly benefited from the preventive treatment with sodium bicarbonate. The incidence of AKI was significantly reduced in low-risk patients while there was no statistically significant difference in the high-risk patient cohort."],["dc.description.sponsorship","Open-Access-Publikationsfonds 2015"],["dc.identifier.doi","10.1186/s13054-015-0906-9"],["dc.identifier.isi","000356480100001"],["dc.identifier.pmid","25899029"],["dc.identifier.purl","https://resolver.sub.uni-goettingen.de/purl?gs-1/13465"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/37351"],["dc.notes.intern","Merged from goescholar"],["dc.notes.status","zu prüfen"],["dc.notes.submitter","Najko"],["dc.publisher","Biomed Central Ltd"],["dc.relation.issn","1364-8535"],["dc.relation.issn","1466-609X"],["dc.rights","CC BY 4.0"],["dc.rights.uri","https://creativecommons.org/licenses/by/4.0"],["dc.title","Does sodium bicarbonate infusion really have no effect on the incidence of acute kidney injury after cardiac surgery? A prospective observational trial"],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dc.type.peerReviewed","yes"],["dc.type.status","published"],["dc.type.version","published_version"],["dspace.entity.type","Publication"]]

[["dc.bibliographiccitation.artnumber","3"],["dc.bibliographiccitation.journal","CRITICAL CARE"],["dc.bibliographiccitation.volume","19"],["dc.contributor.author","Wetz, Anna J."],["dc.contributor.author","Richardt, Eva M."],["dc.contributor.author","Wand, Saskia"],["dc.contributor.author","Kunze, Nils"],["dc.contributor.author","Schotola, Hanna"],["dc.contributor.author","Quintel, Michael"],["dc.contributor.author","Braeuer, Anselm"],["dc.contributor.author","Moerer, Onnen"],["dc.date.accessioned","2018-11-07T10:02:21Z"],["dc.date.available","2018-11-07T10:02:21Z"],["dc.date.issued","2015"],["dc.description.abstract","Introduction: Postoperative acute kidney injury (AKI) is a frequently observed complication after on-pump cardiac surgery (CS) and is associated with adverse patient outcomes. Early identification of patients at risk is essential for the prevention of AKI after CS. In this study, we analysed whether urinary tissue inhibitor of metalloproteinase 2 (TIMP-2) combined with urine insulin-like growth factor binding protein 7 (IGFBP-7) ([TIMP-2] x [IGFBP-7]) is an adequate diagnostic test to identify early AKI after on-pump CS. Methods: In 42 patients undergoing coronary artery bypass graft surgery, we surveyed individual risk factors for AKI and defined AKI by applying the Kidney Disease: Improving Global Outcomes (KDIGO) classification during the day of surgery and the following 2 days after surgery. Concentrations of urinary TIMP-2 multiplied by IGFBP-7 were recorded at four time points: at baseline pre-surgery, at the end of surgery, 4 hours after cardiopulmonary bypass (CPB) and at 8: 00 AM on the first postoperative day. Results: In total, 38% of the patients experienced AKI. The results showed a median baseline [TIMP-2] x [IGFBP-7] concentration of 0.3 (ng/ml)(2)/1,000, decreasing at the end of surgery and then increasing at the next measurement point 4 hours after CPB and further on the first postoperative day. On the first postoperative day, patients with AKI had significantly higher concentrations of [TIMP-2] x [IGFBP-7]. On the day of surgery, the concentration did not significantly differ between patients classified as KDIGO 0 or KDIGO 1 or 2. Previously published cutoff points of 0.3 and 2 were not confirmed in our study cohort. Conclusion: [TIMP-2] x [IGFBP-7] concentration can be used as a diagnostic test to identify patients at increased risk of AKI after CS on the first postoperative day. At earlier time points, no significant difference in [TIMP-2] x [IGFBP-7] concentration was found between patients classified as KDIGO 0 or KDIGO 1 or 2."],["dc.description.sponsorship","Astute Medical"],["dc.identifier.doi","10.1186/s13054-014-0717-4"],["dc.identifier.isi","000351851200001"],["dc.identifier.pmid","25560277"],["dc.identifier.purl","https://resolver.sub.uni-goettingen.de/purl?gs-1/11548"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/38205"],["dc.notes.intern","Merged from goescholar"],["dc.notes.status","zu prüfen"],["dc.notes.submitter","Najko"],["dc.publisher","Biomed Central Ltd"],["dc.relation.issn","1364-8535"],["dc.relation.issn","1466-609X"],["dc.rights","CC BY 4.0"],["dc.rights.uri","https://creativecommons.org/licenses/by/4.0"],["dc.title","Quantification of urinary TIMP-2 and IGFBP-7: an adequate diagnostic test to predict acute kidney injury after cardiac surgery?"],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dc.type.peerReviewed","yes"],["dc.type.status","published"],["dc.type.version","published_version"],["dspace.entity.type","Publication"]]

[["dc.bibliographiccitation.artnumber","55"],["dc.bibliographiccitation.issue","1"],["dc.bibliographiccitation.journal","BMC Anesthesiology"],["dc.bibliographiccitation.volume","19"],["dc.contributor.author","Bräuer, Anselm"],["dc.contributor.author","Müller, Michaela M."],["dc.contributor.author","Wetz, Anna J."],["dc.contributor.author","Quintel, Michael"],["dc.contributor.author","Brandes, Ivo F."],["dc.date.accessioned","2019-07-09T11:51:12Z"],["dc.date.available","2019-07-09T11:51:12Z"],["dc.date.issued","2019"],["dc.description.abstract","Background Perioperative hypothermia is still very common and associated with numerous adverse effects. The effects of benzodiazepines, administered as premedication, on thermoregulation have been studied with conflicting results. We investigated the hypotheses that premedication with flunitrazepam would lower the preoperative core temperature and that prewarming could attenuate this effect. Methods After approval by the local research ethics committee 50 adult cardiac surgical patients were included in this prospective, randomized, controlled, single-centre study with two parallel groups in a university hospital setting. Core temperature was measured using a continuous, non-invasive zero-heat flux thermometer from 30 min before administration of the oral premedication until beginning of surgery. An equal number of patients was randomly allocated via a computer-generated list assigning them to either prewarming or control group using the sealed envelope method for blinding. The intervention itself could not be blinded. In the prewarming group patients received active prewarming using an underbody forced-air warming blanket. The data were analysed using Student’s t-test, Mann-Whitney U-test and Fisher’s exact test. Results Of the randomized 25 patients per group 24 patients per group could be analysed. Initial core temperature was 36.7 ± 0.2 °C and dropped significantly after oral premedication to 36.5 ± 0.3 °C when the patients were leaving the ward and to 36.4 ± 0.3 °C before induction of anaesthesia. The patients of the prewarming group had a significantly higher core temperature at the beginning of surgery (35.8 ± 0.4 °C vs. 35.5 ± 0.5 °C, p = 0.027), although core temperature at induction of anaesthesia was comparable. Despite prewarming, core temperature did not reach baseline level prior to premedication (36.7 ± 0.2 °C). Conclusions Oral premedication with benzodiazepines on the ward lowered core temperature significantly at arrival in the operating room. This drop in core temperature cannot be offset by a short period of active prewarming. Trial registration This trial was prospectively registered with the German registry of clinical trials under the trial number DRKS00005790 on 20th February 2014."],["dc.format.extent","7"],["dc.identifier.doi","10.1186/s12871-019-0725-7"],["dc.identifier.pmid","30987594"],["dc.identifier.purl","https://resolver.sub.uni-goettingen.de/purl?gs-1/16070"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/59895"],["dc.language.iso","en"],["dc.notes.intern","Merged from goescholar"],["dc.publisher","BioMed Central"],["dc.rights","CC BY 4.0"],["dc.rights.uri","https://creativecommons.org/licenses/by/4.0"],["dc.title","Influence of oral premedication and prewarming on core temperature of cardiac surgical patients: a prospective, randomized, controlled trial"],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dc.type.version","published_version"],["dspace.entity.type","Publication"]]